Individual
MOLLIE DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
204 MISSISSIPPI ST S, WYNNE, AR 72396-3025
(870) 208-8499
Mailing address
324 SFC 365, COLT, AR 72326-8003
(870) 270-1388
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
A0308077
AR
101YP2500X
Professional Counselor
Primary
P0808062
AR
Other
Enumeration date
11/08/2006
Last updated
10/14/2019
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